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Organization

MEDICAL EDUCATION ASSISTANCE CORPORATION

Active
Other names
Community Care Wellness Center
Organization subpart
No

Provider details

NPI number
Authorized official
RUSSELL E LEWIS (EXECUTIVE DIRECTOR)
(423) 433-6050
Entity
Organization

Contact information

Practice address
350 CHRISTIAN CHURCH RD, GRAY, TN 37615-4500
(423) 283-3060
(423) 283-7441
Mailing address
PO BOX 2204, JOHNSON CITY, TN 37605-2204
(423) 433-6050
(423) 433-6060

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
MD31588
TN
2080P0006X
Developmental - Behavioral Pediatrics Physician
Primary
MD31588
TN

Other

Enumeration date
12/21/2011
Last updated
12/21/2011
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